Q1.Under ‘human interface/process improvisation’, what are the measures for fraud prevention

 Creation of fraud database


 Ease of data capture


 Extract data output in a desirable format


 Comprehensive claims information


 Ability to detect fraud effectively


Q2.Which type of fraud occurs when people deliberately provide wrong information with regard to the pre-existing illness to influence the underwriting process in the favour of the applicant.

 Underwriting fraud


 Hard fraud


 Soft fraud


 Internal fraud


 External fraud


Q3.__ report sometimes also depends upon the amount of cover opted

 Financial documents




 Proposal form






Q4.In which year was the Malhotra Committee formed?











Q5.____ analysis shows the average amount and the percentage of the total amount paid.

Claims analysis by age bands


 Earned premium


 Earned premium


 Group size distribution


 Claims analysis by sum insured


Q6.___ is one of the measures under technology and process interface for fraud prevention.

 Creating fraud database


 Creating consumer awareness


 Fraud management philosophy and policy


 Effective legislation and judicial action


 Ease of data capture


Q7.__ is not a type of Claims Fraud.

 False claims


 Collusion with TPAs


 Insurance speculation


 Fraud rings


 Collusion with providers


Q8.___ looks after functions like sales, claims intimation, underwriting in case of Social Reinsurance.

Social Service Department of the Local Government




 Insurance agency


 Healthcare provider


 Insurance agency


Q 9.What should be explained to the customer so that the claim process can become smooth and hassle-free with minimum dissonance?

 Company philosophy


Riders and covered expenses/events


 Terms and condition


 Comparison with competitor products


 Policy tenure


Q10.Which of the below statement(s) is/are correct with respect to IRDA’s role? 1. IRDA has specified several regulations for non-life insurance companies in many aspects of business 2. IRDA is very crucial in preventing adverse consequences of the health insurance for the cost of care, consumer satisfaction, fraud, and ethical standards, etc. 3. IRDA is not just a regulatory authority but also plays an active ‘development’ role in health insurance

 Only 1


 Only 2


 Only 3


 Both 1 and 3


 Both 2 and 3

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